The movement of a hospital patient in bed constitutes a serious source of back extension injury to hospital personnel. A review of conventional movement of patients in hospital beds is useful in the understanding of this phenomena.
Hospital beds often require the necessary relative elevation of the head of the bed for sitting up, eating, drinking, visiting, being examined and medical circumstance. During such movements--accommodated largely by the articulation of the hospital bed and the responsive movement of the patient--it is common for the patient to slip relative to the bed. Such slipping motion is almost always from the head of the bed to and towards the foot of the bed. As a result it is required that the patient be restored to the center of the bed. Unfortunately, this a restoration is not independently accomplished by the patient without difficulty.
Presuming that a patient has slipped downward in a hospital bed, and must be repositioned upwardly to and toward the head of the bed, conventional hospital practice requires that this be done manually--without the assistance of the patient. Specifically, groups of hospital personnel gather on the sides of the hospital bed. Thereafter, the patient is lifted--and moved forward in the bed. This transfer is a common source of back injury to hospital personnel.
First, and with regard to the necessity of the hospital personnel to lift the patient, the hospital personnel are immediately adjacent the side of the hospital bed. It is required that the personnel bend at the waist and lean out over the bed. In this position, the muscles of the back can be completely lengthened. In this lengthened position, the muscles are in the weakest and most exposed disposition to possible injury. All strain of lifting is borne by the back in the least favorable position for lifting. In cases where the back is strained beyond its limit, injury such as tearing of the muscles and ligaments can easily occur. Proper training in lifting can minimize the risk of injury, but the nature of this patient transfer places the attendant at increased risk.
Secondly, and when the hospital personnel are in this extended position, in order to move the patient to the head of the bed, the hospital personnel must extend and rotate at the waist--all at a time when their backs are extended and unduly exposed to injury. Indeed, it is during this rotational movement of the extended back that injury most frequently occurs because of increased forces generated in a combined movement.
Finally, this whole process is not particularly comforting to the patient. The patient is "dead weight" during the movement. He has no sense of cooperation--and no sense of security that can come from such cooperation.